1.Effect of Inositol-requiring Enzyme 1 on Cisplatin-induced Apoptosis of Cochlear Hair Cells in Mouse
Journal of Audiology and Speech Pathology 2024;32(2):150-154
Objective To investigate the effect of inositol-requiring enzyme 1(IRE1)on cisplatin-induced ap-optosis of cochlear hair cells in mouse.Methods The cochlear basilar membranes of 500 healthy Kunming mice(3~5 days old)were isolated and cultured in vitro.After 24 hours,they were randomly divided into control group and cisplatin groups(4 μg/ml,8 μg/ml,16 μg/ml and 32 μg/ml),and cultured for another 24 hours.The loss of co-chlear hair cells was observed by fluorescein isothiocyanate(FITC)staining.The apoptosis of cochlear hair cells was observed by TRITC and Hoechst 33258 fluorescence staining.Western blot was used to detect the protein levels of p-IRE1α,p-JNK,Bax and caspase-3 in each group.Results Compared with control group,the hair cell loss and apoptosis rate of hair cells and the protein levels of p-IRE1α,p-JNK,Bax and caspase-3 were significantly increased in cisplatin groups(P<0.01).Furthermore,the expression of p-IRE1α was positively correlated with the expres-sion of Bax and caspase-3 and with the apoptosis rate of hair cells(P<0.05).Conclusion IREI may be involved in the regulation of cisplatin-induced apoptosis in cochlear hair cells.
2.Clinical characteristics and treatment in adults and children with histiocytic necroti-zing lymphadenitis
Xiuwen FEI ; Si LIU ; Bo WANG ; Aimei DONG
Journal of Peking University(Health Sciences) 2024;56(3):533-540
Objective:To analyze the clinical data of histiocytic necrotizing lymphadenitis(HNL),comparing the similarities and differences between children and adults,to deepen the understanding of the disease by clinical physicians,and to improve diagnostic rate and reduce misdiagnosis and mistreat-ment.Methods:The clinical data of hospitalized patients with histiocytic necrotizing lymphadenitis diagnosed by biopsy from January 2010 to August 2023 in Peking University First Hospital were collec-ted,and the clinical features,laboratory examinations,pathological features,treatments with antibiotics and glucocorticoids,and prognosis of histiocytic necrotic lymphadenitis were analyzed.Grouped based on age,the differences of clinical characteristics,laboratory tests,treatment,and prognosis between the children group(<16 years old)and the adult group(≥16 years old)were compared.Results:Among the 81 enrolled patients,there were 42 males and 39 females.The median age was 21(14,29)years,the median duration of disease was 20.0(13.0,30.0)days,and the median length of hospital stay was 13.0(10.0,15.0)days.The first symptoms were fever,lymphadenopathy,and both.All the patients had enlarged lymph nodes with different parts and sizes,96.3%(78 of 81)of the patients had cervical lymphadenopathy,50.6%(41 of 81)had bilateral cervical lymphadenopathy,55.6%(45 of 81)had supraclavicular,axillary or inguinal lymphadenopathy,and the median lymph node diameter was 20.0(20.0,30.0)mm.Only one patient had no fever,the other 80 patients had fever,the median peak body temperature was 39.0(38.0,39.8)℃.Accompanying symptoms:rash(8.6%,7/81),fatigue(34.6%,28/81),night sweating(8.6%,7/81),chills(25.3%,25/81),muscle soreness(13.6%,11/81),and joint pain(6.2%,5/81).There were 17 cases(21.0%,17/81)of hepatosplenomegaly,of which 12 cases(70.6%,12/17)were splenomegaly.68.8%(55/80)of patients had a decrease in white blood cell(WBC)count,with 47.5%(38/80)increased in lymphocyte(LY)proportion,53.4%(39/73)increased in high-sensitivity C-reactive protein(CRP),79.2%(57/72)increased in erythrocyte sedimentation rate(ESR),22.2%(18/81)increased in alanine transaminase(ALT),27.2%(22/81)elevated in aspartate transaminase(AST),and 81.6%(62/76)elevated in lactate dehydrogenase(LDH).All the 81 patients underwent lymph node biopsy,and 77.8%(63/81)of the patients showed that most of the structures in the lymph nodes were destroyed or disappeared,and 16.0%(13/81)of the lymph nodes were still in existence,hyperplasia and normal lymph node were 1.2%(1/81)respectively,and 3.7%(3/81)had normal lymph node structures.Immunohistochemical staining was performed in 67 cases.The percentages of CD3+and CD68(KP1)+were respectively 97.0%(65/67),and MPO+were 94.0%(63/67).In the study,51 patients(63.0%,51/81)were treated with glucocorticoid therapy after diagnosis.The median time for temperature to return to normal was 1.0(1.0,4.0)days after glu-cocorticoid therapy.when the glucocorticoid treatment worked best,the body temperature could drop to normal on the same day.There were significant differences in length of stay,predisposing factors,chills,the rate of increase in high-sensitivity CRP,antibiotic and glucocorticoid treatment between the adults and children groups(P<0.05).Conclusion:In clinical practice,if there are cases with unexplained fever,su-perficial lymph node enlargement,and reduced white blood cells as clinical characteristics,and general anti-biotics treatment is ineffective,histiocytic necrotic lymphadenitis should be considered.Lymph node biopsy should be performed as early as possible to clarify the diagnosis,reduce misdiagnosis and mistreatment,and symptomatic treatment should be the main treatment.Glucocorticoids therapy has a definite therapeutic effect.
3.Influencing factors of anxiety symptoms in firstborn preschool children
Aimei YE ; Feng CHEN ; Yuzhong YE ; Changcan HUANG ; Junmin LI ; Yanshan WANG ; Dongxi LU ; Mujin GUO ; Weige WU ; Xiaoling LIN ; Dali LU
Sichuan Mental Health 2024;37(6):537-542
BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However, there is insufficient research on anxiety symptoms in preschool children, especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children, so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021, a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior (SIB) and Spence Preschool Anxiety Scale (SPAS) were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 (99.64%) valid questionnaires were collected. Anxiety symptoms were detected in 344(4.09%) firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration, monthly family income, maternal age, maternal education level, paternal education level, family living conditions and whether they are left-behind children (χ2/t=9.906, 33.490, 5.136, 13.485, 9.690, 17.332, 21.975, P<0.05 or 0.01). Compared with non-anxiety group, children in the anxiety group scored higher on the SIB dimensions of rivalry, aggression and avoidance (t=165.322, 74.471, 286.419, P<0.01), and lower on companionship, empathy and teaching (t=59.133, 42.417, 39.112, P<0.01). Risk factors for anxiety symptoms in firstborn preschool children included left-behind children, as well as negative sibling relationships characterized by rivalry and avoidance (OR=1.195, 1.143, 1.260, P<0.05 or 0.01). ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships, characterized by competition and avoidance, may also contribute to the emergence of anxiety symptoms in firstborn preschool children.
4.Dexmedetomidine protects myocardium from ischemia/reperfusion injury by down regulating expression of Dectin-1 and inhibiting immune cells infiltration
Siyu CHEN ; Jianjiang WU ; Aimei LI ; Li DENG ; Zhenfei HU ; Jiang WANG
Chinese Journal of Immunology 2024;40(9):1843-1849
Objective:To explore the molecular mechanism of dexmedetomidine(Dex)protecting ischemia/reperfusion(I/R)myocardium.Methods:Wild type mice were grouped into control(Control)group,sham operation(Sham)group,WT I/R group,WT Dex group,and Dectin-1 knock out mice were grouped into KO I/R group and KO Dex group in the in vivo study(n=6).TTC stain-ing was used to determine the myocardial infarction area(%)of the above six groups of mice.HE staining and pathological analyze was used to determine the myocardial injury.Serum TNF-α,IL-6 and IL-10 levels in mice were detected by ELISA.Flow cytometry(FCM)was used to count and sort of infiltrating M2 macrophages and neutrophils in myocardium.qPCR assay was used to determine the Dectin-1 mRNA expression in the above sorted cells.Results:TTC results showed that there was no myocardial infarction in the mice of Control group and Sham group.Compared with the WT I/R group,the infarct volume was significantly lower in WT Dex group,KO I/R group and KO Dex group(P<0.05).Compared with the KO I/R group,the infarct volume was reduced in KO Dex group(P<0.05).The results of HE staining showed that the myocardial fibers of the WT I/R group of mice were disorderly arranged,with a large number of broken myocardial fibers,while the myocardial fibers of the WT Dex group,KO I/R group and KO Dex group of mice had a little breakage,the structural damage was not significant,and the myocardial arrangement was relatively neat.The degree of myocardi-al injury of mice in KO Dex group were less than that in KO I/R group mice.ELISA results showed that compared with Sham group,the serum TNF-α and IL-6 levels of the mice in WT I/R group were significantly increased,and the IL-10 level was significantly de-creased.Compared with WT I/R group,serum TNF-α and IL-6 levels of the mice in WT Dex group and KO I/R group were significant-ly decreased,and IL-10 level was significantly increased.Compared with KO I/R group,the serum TNF-α and IL-6 levels of the mice in KO Dex group were significantly decreased,and the IL-10 level was significantly increased(P<0.05).FCM cell counting results showed that compared with Sham group,a large number of M2 macrophages and neutrophils were infiltrated in the myocardium of WT I/R group of mice(P<0.05).Compared with WT I/R group,the M2 macrophages and neutrophils infiltrated in the myocardium were significantly decreased in WT Dex group,KO I/R group and KO Dex group of mice(P<0.05).While there was no significant differ-ence between the KO I/R group and the KO Dex group mice(P>0.05).qPCR results showed that compared with Sham group,the ex-pression level of Dectin-1 mRNA in the myocardial infiltrated M2 macrophages and neutrophils were significantly up-regulated in WT I/R group of mice(P<0.05).While compared with WT I/R group,the expression level of Dectin-1 mRNA in Dex group of mice was sig-nificantly lower(P<0.05).Mice in KO I/R group and KO Dex group did not express Dectin-1.Conclusion:The protective mecha-nisms of Dex preconditioning on I/R injured myocardium involves reducing the infiltrating number of M2 macrophages and neutrophils in myocardium after I/R injury,which may be achieved by inhibiting the expression of Dectin-1.
5.Combination tests of drug sensitivity for carbapenem-resistant Acinetobacter baumannii
Aimei SU ; Yongtao WEI ; Dongping WANG
Chinese Journal of Clinical Laboratory Science 2024;42(4):267-271
Objective To analyze the distribution and drug resistance patterns of carbapenem-resistant Acinetobacter baumannii(CRAB),and evaluate the antimicrobial effects in vitro of colistin(COL)combined with cefoperazone/sulbactam(SCF),tigecycline(TGC),imipenem(IPM),meropenem(MEM),amikacin(AK),and levofloxacin(LEV)against CRAB to provide guidance for anti-infective therapy.Methods A total of 75 non-duplicate CRAB strains isolated from clinical specimens in 2022 were collected.WHONET 5.6 software was used for retrospective analysis of their clinical distribution and resistance profiles.Among them,25 strains were selected for combined antimicrobial susceptibility tests using broth microdilution to determine minimum inhibitory concentrations(MICs).The fractional inhibitory concentration(FIC)index was calculated based on checkerboard method to assess the combined effects.Results In 2022,a total of 145 Acinetobacter baumannii strains were isolated,including 75 CRAB(detection rate of 51.7%).CRAB was most prevalent in the patients over 70 years old(40.0%),mainly from blood(41.3%)and sputum(37.3%)specimens,and the intensive care unit was the top isolating department.All the 75 CRAB strains were resistant to piperacillin,piperacillin/tazobactam,ceftriaxone,1PM and MEM with resistance rates of 100%.The resistance rates for ampicillin/sulbactam,cefepime and tri-methoprim/sulfamethoxazole were all exceeded 95%.The resistance rates were 86.7%for LEV,82.7%for SCF,77.4%for AK,2.4%for TGC,and 0.0%for COL.The results of combined tests of 25 strains revealed the synergy rates of 92%and 80%for COL+SCF and COL+TGC respectively with sums of both synergy and additive rates of 100%.Synergy rates for COL combined with IPM,MEM,AK and LEV were 64%,72%,56%and 48%respectively.No antagonism was observed in any combination.Conclusion The drug resist-ance of CRAB exhibited high levels at our hospital,and the elderly and ICU patients were the major susceptible populations.Among all the combinations tests,COL+SCF showed optimal synergy while COL+LEV only had the lowest combined effect with the findings that warrants clinical consideration.
6.Analysis for drug sensitivity of 11 antimicrobial in vitro combination regimenagainst carbapenem-resistant Enterobacteriaceae
Dongping WANG ; Aimei SU ; Xinyi HAN
Chinese Journal of Clinical Laboratory Science 2024;42(6):430-435
Objective To observe the susceptibility test result in vitro of the combination of two drugs to carbapenem-resistant Enter-obacteriaceae(CRE)for screening the effective anti-infective therapy.Methods A total of 60 CRE strains which were isolated from the specimens from the clinic of Qingdao Eighth People's Hospital from January 2023 to December 2023.Carbapenem enzyme type was detected by colloidal gold immunochromatography.The minimal inhibitory concentration(MIC)was determined by micro broth dilution method.Ceftazidime/avibactam(CZA)combined with aztreonam(ATM),COL combined with tigecycline(TGC),meropenem(MEM),cefoperazone/sulbactam(SCF),amikacin(AK)and levofloxacin(LEV),TGC combined with MEM,SCF and AK,MEM combined with SCF and ertapenem(ETP)were performed by the checkerboard dilution method respectively.Fractional inhibitory con-centration(FIC)index was used to determine the combined effects.Results Carbapenem enzyme was detected in all the 60 CRE strains,including 49 Klebsiella pneumoniae carbapenemases(KPC)-type,10 New Delhi metallo-β-lactamase(NDM)-type and 1 Imi-penem enzyme(IMP)-type.The MICs of CZA to 49 KPC-producing strains were ≤8 mg/L,showing all sensitive,and to 11 NDM-and IMP-producing strains were>128 mg/L,showing all resistant.The synergy rate of CZA was 100%after combining with ATM.MEM combined with SCF had the highest synergy rate of 63.4%,and the sum of synergistic rate and addition rate was 96.7%.The syn-ergistic rate and additive rate of TGC combined with AK were the lowest,which was 31.7%.Among KPC and NDM enzyme types strains,the sum of synergy rate and addition rate of MEM combined with SCF were the highest,which were 100.0%and 80.0%respec-tively.The sum of synergy rate and addition rate of COL combined with LEV were the lowest,which were 32.6%and 30.0%.None of the 11 combination regimens showed antagonistic effect.The MICrange,MIC50 and MIC90 of combination regimens for CRE strains were decreased to some extent compared with those of each single drug.Conclusion CZA alone or in combination with ATM were effective for CRE strains.The MEM combined with SCF had the highest synergy rate and addition rate,which could provide reference for clinical experience medication.
7.Screening for hearing health and associated factors among students from 4 universities in Taiyuan
LIU Aimei, ZHOU Liyuan, WANG Huijuan
Chinese Journal of School Health 2023;44(4):563-566
Objective:
To investigate the current situation of hearing health among college students and associated factors, and to provide a basis for universities and relevant departments to carry out hearing health work.
Methods:
By using stratified random sampling method, 1306 students from 4 universities in Taiyuan were screened for hearing loss and were investigated with a questionnaire from March to November 2021. Data were analyzed by using the SPSS 19.0 statistical.
Results:
The detection rate of hearing loss was 31.70%. The majority (51.91%) failed to pass the 4 000 Hz hearing screening. The total awareness rate of hearing problems was 58.96%. Logistic regression analysis showed that the total daily usage time of earphones >4 h/d, the duration of using earphones >1 h/time were positively correlated with positive screening for hearing loss among college students( OR=1.23, 1.14, P < 0.01), and good awareness of hearing health care and highest education of parents were negatively correlated with positive screening for hearing loss among coollege students( OR =0.54, 0.76, 0.37, P <0.05).
Conclusion
The awareness of hearing health care among college students is low. Universities and relevant departments should take targeted measures to provide the best hearing health care services.
8.Radiotherapy combined with immunotherapy could improve the immune infiltration of melanoma in mice and enhance the abscopal effect
Yufeng ZHENG ; Xue LIU ; Na LI ; Aimei ZHAO ; Zhiqiang SUN ; Meihua WANG ; Judong LUO
Radiation Oncology Journal 2023;41(2):129-139
Purpose:
To analyze the gene mutation, immune infiltration and tumor growth of primary tumor and distant tumor under different treatment modes.
Materials and Methods:
Twenty B16 murine melanoma cells were injected subcutaneously into the of both sides of the thigh, simulating a primary tumor and a secondary tumor impacted by the abscopal effect, respectively. They were divided into blank control group, immunotherapy group, radiotherapy group, and radiotherapy combined immunotherapy group. During this period, tumor volume was measured, and RNA sequencing was performed on tumor samples after the test. R software was used to analyze differentially expressed genes, functional enrichment, and immune infiltration.
Results:
We found that any treatment mode could cause changes in differentially expressed genes, especially the combination treatment. The different therapeutic effects might be caused by gene expression. In addition, the proportions of infiltrating immune cells in the irradiated and abscopal tumors were different. In the combination treatment group, T-cell infiltration in the irradiated site was the most obvious. In the immunotherapy group, CD8+ T-cell infiltration in the abscopal tumor site was obvious, but immunotherapy alone might have a poor prognosis. Whether the irradiated or abscopal tumor was evaluated, radiotherapy combined with anti-programmed cell death protein 1 (anti-PD-1) therapy produced the most obvious tumor control and might have a positive impact on prognosis.
Conclusion
Combination therapy not only improves the immune microenvironment but may also have a positive impact on prognosis.
9.Surgical efficacy and prognosis influencing factors of hilar cholangiocarcinoma based on multi-disciplinary diagnosis and treatment
Liang MAO ; Yifei YANG ; Alexer ABAYDULLA ; Tie ZHOU ; Xu FU ; Hao CHENG ; Jing ZHANG ; Youjun LIANG ; Yinyin FAN ; Wentao KONG ; Jian HE ; Aimei LI ; Min TANG ; Qun ZHOU ; Qibin HE ; Yi WANG ; Lei WANG ; Weiwei KONG ; Jie SHEN ; Baorui LIU ; Jun CHEN ; Jiong SHI ; Qi LI ; Zhao LIU ; Yudong QIU
Chinese Journal of Digestive Surgery 2023;22(7):873-883
Objective:To investigate the surgical efficacy and prognosis influencing factors of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment.Methods:The retrospective cohort study was conducted. The clinicopathological data of 91 patients with hilar cholangiocarcinoma who underwent surgery in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from April 2004 to April 2021 were collected. There were 59 males and 32 females, aged (61±10)years. Patients who were admitted from April 2004 to March 2014 underwent traditional surgical diagnosis and treatment, and patients who were admitted from April 2014 to April 2021 underwent multidisciplinary diagnosis and treatment. Observation indica-tors: (1) surgical situations; (2) postoperative situations; (3) postoperative pathological examina-tions; (4) postoperative prognosis analysis; (5) influencing factors of postoperative prognosis. Follow-up was conducted using telephone interview and outpatient examination. Patients were followed up once every 6 months after surgery to detect survival. The follow-up was up to April 2023. Measure-ment data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Comparison of ordinal data was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. The Kaplan-Meier method was used to draw survival curve and calculate survival rate. The Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard model. Results:(1) Surgical situations. Of the 91 patients, there were 65 cases receiving hemi- or expanded hemi-hepatectomy, 13 cases receiving tri-hepatectomy, 9 cases receiving partial hepatectomy, 4 cases receiving extrahepatic bile duct resection. There were 24 cases receiving combined vein resection and reconstruction, 8 cases receiving combined pancreaticoduodenectomy, 6 cases receiving com-bined hepatic artery resection and reconstruction, including 24 cases receiving extended radical surgery (tri-hepatectomy, hepatic artery resection and reconstruction, hepatopancreaticoduodenec-tomy). The operation time, volume of intraoperative blood loss and intraoperative blood transfusion rate of 91 patients was (590±124)minutes, 800(range, 500?1 200)mL and 75.8%(69/91), respectively. Of the 91 patients, cases receiving extended radical surgery, the volume of intraoperative blood loss were 4, 650(range, 300?1 000)mL in the 31 patients who were admitted from April 2004 to March 2014, versus 20, 875 (range, 500?1 375)mL in the 60 patients who were admitted from April 2014 to April 2021, showing significant differences between them ( χ2=4.39, Z=0.31, P<0.05). (2) Post-operative situations. The postoperative duration of hospital stay and cases with postoperative infectious complications were (27±17)days and 50 in the 91 patients. Cases with abdominal infection, cases with infection of incision, cases with bacteremia and cases with pulmonary infection were 43, 7, 5, 8 in the 91 patients. One patient might have multiple infectious complications. Cases with bile leakage, cases with delayed gastric emptying, cases with chylous leakage, cases with liver failure, cases with pancreatic fistula, cases with intraperitoneal hemorrhage, cases with reoperation, cases dead during the postoperative 90 days were 30, 9, 9, 6, 5, 3, 6, 3 in the 91 patients. Cases with abdominal infection was 10 in the 31 patients who were admitted from April 2004 to March 2014, versus 33 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=4.24, P<0.05). Cases dead during the postoperative 90 days was 3 in the 31 patients who were admitted from April 2004 to March 2014, versus 0 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( P<0.05). (3) Post-operative pathological examinations. Of the 91 patients, cases with Bismuth type as type Ⅰ?Ⅱ, type Ⅲ, type Ⅳ, cases with T staging as Tis stage, T1 stage, T2a?2b stage, T3 stage, T4 stage, cases with N staging as N0 stage, N1 stage, N2 stage, cases with M staging as M0 stage, M1 stage, cases with TNM staging as 0 stage, Ⅰ stage, Ⅱ stage, Ⅲ stage, ⅣA stage, ⅣB stage, cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 46, 30, 1, 9, 25, 30, 26, 49, 36, 6, 85, 6, 1, 7, 13, 58, 6, 6, 63, 28. Cases with R 0 radical resection, cases with R 1 or R 2 resection were 15, 16 in the 31 patients who were admitted from April 2004 to March 2014, versus 48, 12 in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=9.59, P<0.05). (4) Postoperative prognosis analysis. Of the 91 patients, 3 cases who died within 90 days after surgery were excluded, and the 5-year overall survival rate and median overall survival time of the rest of 88 cases were 44.7% and 55 months. The 5-year overall survival rate was 33.5% in the 28 patients who were admitted from April 2004 to March 2014, versus 50.4% in the 60 patients who were admitted from April 2014 to April 2021, showing a significant difference between them ( χ2=5.31, P<0.05). Results of further analysis showed that the corresponding 5-year overall survival rate of cases without lymph node metastasis was 43.8% in the 16 patients who were admitted from April 2004 to March 2014, versus 61.6% in the 31 patients who were admitted from April 2014 to April 2021. There was a significant difference in the 5-year overall survival rate between these patients without lymph node metastasis ( χ2=3.98, P<0.05). The corresponding 5-year overall survival rate of cases with lymph node metastasis was 18.5% in the 12 patients who were admitted from April 2004 to March 2014, versus 37.7% in the 29 patients who were admitted from April 2014 to April 2021. There was no significant difference in the 5-year overall survival rate between these patients with lymph node metastasis ( χ2=2.25, P>0.05). (5) Influencing factors of postoperative prognosis. Results of multivariate analysis showed that poorly differentiated tumor and R 1 or R 2 resection were inde-pendent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma ( hazard ratio=2.62, 2.71, 95% confidence interval as 1.30?5.29, 1.30?5.69, P<0.05). Conclusions:Compared with traditional surgical diagnosis and treatment, treatment of hilar cholangiocarcinoma based on multidisciplinary diagnosis and treatment can expand surgical indications, reduce proportion of dead patients within 90 days after surgery, improve proportation of radical resection and long-term survival rate. Poorly differentiated tumor and R 1 or R 2 resection are independent risk factors influencing prognosis after surgical treatment of hilar cholangiocarcinoma.
10.Analysis of monitoring results of coal-burning-borne endemic arsenism in Shaanxi Province from 2015 to 2020
Rong ZHOU ; Xiaoqian LI ; Zhongxue FAN ; Chengbao CUI ; Aimei BAI ; Ying DENG ; Meixuan LU ; Xiong GUO ; Xi WANG ; Yujie NING
Chinese Journal of Endemiology 2023;42(1):30-35
Objective:To learn about the changes of the condition of coal-burning-borne endemic arsenism, the use of improved stoves and the formation of health-related behaviors in Shaanxi Province, and evaluate the effect of prevention and control measures.Methods:From 2015 to 2020, according to the "Implementation Plan for Monitoring Coal-burning-borne Endemic Arsenism in Shaanxi Province", regular field surveys were carried out in 4 natural villages, 2 counties in Ankang City and Hanzhong City, Shaanxi Province, to learn about the basic prevention and control situation in the monitoring village. Using the simple random sampling method, 10 families in each village were selected to investigate the use of stoves and the formation of health-related behaviors, and 5 of these families were selected to collect coal samples for arsenic content determination in accordance with the "Determination of Arsenic in Coal" (GB/T 3058-2008). According to the "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015), the condition of the people exposed to high arsenic coal in the monitoring village was investigated. Urine samples of 30 adult patients (half males and half females) with arsenic poisoning were collected, the content of arsenic in urine was determined by the "Urine-Determination of Arsenic-Silver Diethyldithiocarbamate-Triethanolamine-Spectrophotometric Method" (WS/T 28-1996).Results:A total of 240 households were monitored in the past 6 years, and the quality conformance and correct utilization rates of improved stoves in the households monitored in the disease areas remained at 100.00% in 2018 - 2020. The utilization rate of clean energy increased from 75.00% (30/40) in 2015 to 100.00% (40/40) in 2018 - 2020 (χ 2trend = 25.5, P < 0.001). The 73.75% (177/240) of households using a variety of clean energy. From 2018 to 2020, the correct drying, storage and pre-processing washing rates of corn and pepper continued to reach 100.00% (40/40). The arsenic content of coal ( n = 120) in the disease areas was (118.09 ± 57.91) mg/kg, ranging from 16.70 to 280.94 mg/kg. The detection rate of arsenic poisoning decreased from 6.34% (231/3 646) in 2015 to 2.90% (109/3 754) in 2020 (χ 2trend = 121.8, P < 0.001), and no skin cancer or Bowen's disease was detected. The geometric mean of arsenic content in urine ( n = 720) was 0.038 1 mg/L, ranging from 0.000 5 to 0.312 9 mg/L. Conclusions:The condition of coal-burning-borne endemic arsenism areas in Shaanxi Province has reached the national elimination standard. The quality and correct utilization rate of improved stoves and the rate of using clean energy have increased. The healthy-related behaviors the people in the endemic areas have been basically formed. The prevention and control work has achieved good results.


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